Permit -- --- � _
�
CI1 � TIGARD ELECTRICAL PERMIT —
RESTRICTED ENERGY
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #: ELR95-0211
13125 SW Hall Blvd. Tigard, Oregon 9722 3.8199 (503) 639-4171 DATE ISSUED: 11/15/95
PARCEL: 2S104CA-02700
SITE ADDRESS...: 13543 SW LAUREN LN
SUBDIVISION....: HILLSHIRE ZONING:R-7 PD
BLOCK..........: LOT.............:027
Project Description:
• _ _ _
A. RESIDENTIAL --- B. COMMERCIAL ----------
AUDIO & STEREO.,, :X AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM....:X BOILER ^ LANDSCAPE/IRRIGAT..:
GARAGE OPENER.,.. : X CLOCK.. . ........ : MEDICAL.. .. . ... . . .. :
HVAC.. .. .... .. ... :X DATA/TELE COMM. . : NURSE CALLS. .. . . . .. :
VACUUM SYSTEM.... :X FIRE ALARM. .. ... : OUTDOOR LANDSC LITE:
OTHER: ::X HVAC............: PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER..:
TOTAL # OF SYSTEMS: 0
Applicant: -- FEES ---- —
GARY'S VACUFLO INC type amount by date recpt
9015 SE FLAVEL PRMT $ 40.00 CJS 11/15/95 95-272917
5PCT $ 2.00 CJS 11/15/95 95-272917
PORTLAND OR 97266
Phone #:
Contractor: — — — -----
GARY'S VACUFLO $ 42.00 TOTAL
9015 SE FLAVEL
REQUIRED INSPECTIONS
PORTLAND OR 97226 Ceiling Cover Elect'l Service
Phone #: 503-775-2042 Wall Cover Elect'l Final
Reg #..: 26728
This permit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Permitee Signature
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more .
than 180 days. Issued By
—OWNER INSTALLATION ONLY — — --
The installation is being made on property I own which is not intended for
sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
—CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' N: / ^�uw DATE: //—
LICENSE NO: _ _ _____
.Call for inspection — 639-4175
'
4 , Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT # Q a
� 7 ��� ° ��� d ��mry� IN��II�i��I
Phone
FAX (503) 684-7297 1 DATE ISSUED \`1 6 \ q 5
,_,_41, ` - TDD No. (503) 684 -2772
CITY OF TIGARD Inspection (503) 639 -4175 ISSUED BY Ck CrA,.,
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
35 L A 3 Sr (-J L A-u KeN Leer&
Address ?aa3 RESIDENTIAL — Restricted S Fee $40.00 cuut
(FOR OR A LL LL SYSTEMS) Q
C
po-aiul
ity State Zip Check Type of Work Involved: '�" -- `'
PERMITS ARE NON - TRANSFERABLE AND NON - REFUNDABLE AND EXPIRE IF WORK �V
IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR �� �AUdio and Stereo Systems*
180 DAYS. L(Y Burglar Alarm
/rage Door Opener*
2. CONTRACTOR APPLICATION ,L�.f,��/Heating, Ventilation and Air Conditioning System*
Contractor Type II /Vacuum Systems* .
D Other
Address
i COMMERCIAL — Fee for each system $40.00
GARY'S VACUFLO, INC. 775 -2042 (SEE OAR 918 260 - 260)
9015 SE FLAVEL. PTLD, OR 97266
DATE: // /_/,57 ,$ JOB# Check Type of Work Involved:
OWNER: i U __M_________ ❑ Audio and Stereo Systems*
CLE 26728. JLE 985. CCB: 69047 ❑ Boiler Controls
\ Phone # ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No
❑ Instrumentation
Address ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
City State Zip ❑ Medical
This permit is issued under OAR 918- 320 -370. This applicant agrees to make only ❑ Nurse Calls
restricted energy installations (100 volt amps or less) under this permit and to do the ❑ Outdoor Landscape Lighting*
following:
1. Only use electrical licensed persons to do installations where required. (Certain ❑ Protective Signaling
residential and other transactions are exempt from licensing. These have ❑ Other
asterisks( *). All others need licensing).
2. Call for an inspection when all of the installations under this permit are ready
for inspection at 503- 639 -4175.
❑ Number of Systems
3. Purchase separate permits for all installations that are not ready for inspection
when the inspector is out to inspect under this permit. * No licenses are required. Licenses are required for all other installations.
4. Assume responsibility for assuring that all corrections required by the inspector
are done, and
5. Assume responsibility for calling for a final inspection when all of the corrections 5. FEES
are completed.
The person signing for this permit must be the applicant or a person a. Enter Fees $ �D, G C,
authorized to bind the applicant.
ao
C�i lk :; ,, ° b. 5% Surcharge (.05 x total above) $ y
ignature
-
TOTAL $ ti; 0-0
Authority if other than applicant
ENERGAP.CHP
7/22/99 Activities for Case #: ELR95 -00211
2:39:12 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
ELRA003 Application received 11/15/95 CJS RECD TMP 11/15/95
ELRA010 Permit created 11/15/95 CJS RECD TMP 11/15/95
ELRA700 Ceiling Cover 11/15/95 TMP 11/15/95
ELRA720 Wall Cover 11/15/95 TMP 11/15/95
ELRA730 Elect'I Service 11/15/95 TMP 11/15/95
ELRA799 Elect'I Final 11/15/95 2/16/96 GS APP GES 2/16/96
ELRA500 (F) Issue permit 11/15/95 CJS PASS TMP 11/15/95
ELRA800 Case finaled • 2/16/96 GS - APP GES 2/16/96
•
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